S 300 IS

106th CONGRESS

1st Session

S. 300

To improve the access and choice of patients to quality, affordable health care.

IN THE SENATE OF THE UNITED STATES

January 22, 1999

Mr. LOTT (for himself, Mr. NICKLES, Ms. COLLINS, Mr. FRIST, Mr. GRAMM, Mr. HAGEL, Mr. JEFFORDS, Mr. ROTH, Mr. SANTORUM, Mr. MACK, Mr. CRAIG, Mr. COVERDELL, Mr. MCCONNELL, Mr. ABRAHAM, Mr. ALLARD, Mr. ASHCROFT, Mr. BENNETT, Mr. BOND, Mr. BROWNBACK, Mr. BUNNING, Mr. BURNS, Mr. CAMPBELL, Mr. COCHRAN, Mr. DEWINE, Mr. DOMENICI, Mr. ENZI, Mr. GORTON, Mr. GRAMS, Mr. GRASSLEY, Mr. GREGG, Mr. HATCH, Mr. HELMS, Mr. HUTCHINSON, Mrs. HUTCHISON, Mr. INHOFE, Mr. LUGAR, Mr. MCCAIN, Mr. MURKOWSKI, Mr. ROBERTS, Mr. SESSIONS, Mr. SHELBY, Mr. SMITH of New Hampshire, Mr. SMITH of Oregon, Ms. SNOWE, Mr. STEVENS, Mr. THOMAS, Mr. THOMPSON, Mr. THURMOND, Mr. VOINOVICH, and Mr. WARNER) introduced the following bill; which was read twice and referred to the Committee on Finance


A BILL

To improve the access and choice of patients to quality, affordable health care.

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

TITLE I--PATIENTS' BILL OF RIGHTS

Subtitle A--Right to Advice and Care

`SUBPART C--PATIENT RIGHT TO MEDICAL ADVICE AND CARE

`Sec. 721. Patient access to emergency medical care.

`Sec. 722. Offering of choice of coverage options.

`Sec. 723. Patient access to obstetric and gynecological care.

`Sec. 724. Patient access to pediatric care.

`Sec. 725. Continuity of care.

`Sec. 726. Protection of patient-provider communications.

`Sec. 727. Generally applicable provision.

Subtitle B--Right to Information About Plans and Providers

Subtitle C--Right to Hold Health Plans Accountable

Subtitle D--Miscellaneous Provisions

TITLE II--INDIVIDUAL RIGHTS WITH RESPECT TO PERSONAL MEDICAL INFORMATION

Subtitle A--Access to Medical Records

Subtitle B--Establishment of Safeguards

Subtitle C--Enforcement; Definitions

TITLE III--GENETIC INFORMATION AND SERVICES

TITLE IV--HEALTHCARE RESEARCH AND QUALITY

`TITLE IX--AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

`Part A--Establishment and General Duties

`Sec. 901. Mission and duties.

`Sec. 902. General authorities.

`Part B--Healthcare Improvement Research

`Sec. 911. Healthcare outcome improvement research.

`Sec. 912. Private-public partnerships to improve organization and delivery.

`Sec. 913. Information on quality and cost of care.

`Sec. 914. Information systems for healthcare improvement.

`Sec. 915. Research supporting primary care and access in underserved areas.

`Sec. 916. Clinical practice and technology innovation.

`Sec. 917. Coordination of Federal Government quality improvement efforts.

`Part C--General Provisions

`Sec. 921. Advisory Council for Healthcare Research and Quality.

`Sec. 922. Peer review with respect to grants and contracts.

`Sec. 923. Certain provisions with respect to development, collection, and dissemination of data.

`Sec. 924. Dissemination of information.

`Sec. 925. Additional provisions with respect to grants and contracts.

`Sec. 926. Certain administrative authorities.

`Sec. 927. Funding.

`Sec. 928. Definitions.

TITLE V--ENHANCED ACCESS TO HEALTH INSURANCE COVERAGE

TITLE I--PATIENTS' BILL OF RIGHTS

Subtitle A--Right to Advice and Care

SEC. 101. PATIENT RIGHT TO MEDICAL ADVICE AND CARE.

`Subpart C--Patient Right to Medical Advice and Care

`SEC. 721. PATIENT ACCESS TO EMERGENCY MEDICAL CARE.

emergency medical care (as defined in subsection (c)), except for items or services specifically excluded--

`SEC. 722. OFFERING OF CHOICE OF COVERAGE OPTIONS.

this paragraph, the provisions of subparagraph (C) of section 712(c)(1) shall apply in determining employer size.

`SEC. 723. PATIENT ACCESS TO OBSTETRIC AND GYNECOLOGICAL CARE.

`SEC. 724. PATIENT ACCESS TO PEDIATRIC CARE.

`SEC. 725. CONTINUITY OF CARE.

`SEC. 726. PROTECTION OF PATIENT-PROVIDER COMMUNICATIONS.

`SEC. 727. GENERALLY APPLICABLE PROVISION.

`SUBPART C--PATIENT RIGHT TO MEDICAL ADVICE AND CARE

SEC. 102. EFFECTIVE DATE AND RELATED RULES.

Subtitle B--Right to Information About Plans and Providers

SEC. 111. INFORMATION ABOUT PLANS.

`SEC. 714. HEALTH PLAN COMPARATIVE INFORMATION.

health services (including telephone numbers and mailing addresses), including referrals for specialty care.

amended by striking `section 711, and inserting `sections 711 and 714'.

`Sec. 714. Health plan comparative information.'.

SEC. 112. INFORMATION ABOUT PROVIDERS.

Subtitle C--Right to Hold Health Plans Accountable

SEC. 121. AMENDMENT TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.

`SEC. 503. CLAIMS PROCEDURE, COVERAGE DETERMINATION, GRIEVANCES AND APPEALS.

terms and conditions of the contract between the plan or issuer and the enrollee;

Security Act of 1974 is amended by striking the item relating to section 503 and inserting the following new item:

Subtitle D--Miscellaneous Provisions

SEC. 131. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986.

`Sec. 9813. Standard relating to Patients' bill of rights.'; and

`SEC. 9813. STANDARD RELATING TO PATIENTS' BILL OF RIGHTS.

TITLE II--INDIVIDUAL RIGHTS WITH RESPECT TO PERSONAL MEDICAL INFORMATION

SEC. 201. SHORT TITLE.

Subtitle A--Access to Medical Records

SEC. 211. INSPECTION AND COPYING OF PROTECTED HEALTH INFORMATION.

SEC. 212. AMENDMENT OF PROTECTED HEALTH INFORMATION.

SEC. 213. NOTICE OF CONFIDENTIALITY PRACTICES.

Subtitle B--Establishment of Safeguards

SEC. 221. ESTABLISHMENT OF SAFEGUARDS.

Subtitle C--Enforcement; Definitions

SEC. 231. CIVIL PENALTY.

SEC. 232. DEFINITIONS.

SEC. 233. EFFECTIVE DATE.

TITLE III--GENETIC INFORMATION AND SERVICES

SEC. 301. SHORT TITLE.

SEC. 302. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.

`SEC. 714. PROHIBITING PREMIUM DISCRIMINATION AGAINST GROUPS ON THE BASIS OF PREDICTIVE GENETIC INFORMATION.

SEC. 303. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

`SEC. 2707. PROHIBITING PREMIUM DISCRIMINATION AGAINST GROUPS ON THE BASIS OF PREDICTIVE GENETIC INFORMATION IN THE GROUP MARKET.

`SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS OF PREDICTIVE GENETIC INFORMATION.

a part of a request under subparagraph (A), the health insurance issuer shall provide to the individual or dependent a description of the procedures in place to safeguard the confidentiality, as described in sections 213 and 221 of the Patients' Bill of Rights Plus Act, of such individually identifiable information.'.

SEC. 304. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986.

`SEC. 9814. PROHIBITING HEALTH DISCRIMINATION AGAINST GROUPS ON THE BASIS OF PREDICTIVE GENETIC INFORMATION.

TITLE IV--HEALTHCARE RESEARCH AND QUALITY

SEC. 401. SHORT TITLE.

SEC. 402. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

`TITLE IX--AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

`PART A--ESTABLISHMENT AND GENERAL DUTIES

`SEC. 901. MISSION AND DUTIES.

`SEC. 902. GENERAL AUTHORITIES.

`PART B--HEALTHCARE IMPROVEMENT RESEARCH

`SEC. 911. HEALTHCARE OUTCOME IMPROVEMENT RESEARCH.

`SEC. 912. PRIVATE-PUBLIC PARTNERSHIPS TO IMPROVE ORGANIZATION AND DELIVERY.

`SEC. 913. INFORMATION ON QUALITY AND COST OF CARE.

`SEC. 914. INFORMATION SYSTEMS FOR HEALTHCARE IMPROVEMENT.

`SEC. 915. RESEARCH SUPPORTING PRIMARY CARE AND ACCESS IN UNDERSERVED AREAS.

`SEC. 916. CLINICAL PRACTICE AND TECHNOLOGY INNOVATION.

grants to, or enter into cooperative agreements or contracts with, entities described in paragraph (4) for the purpose of conducting assessments of experimental, emerging, existing, or potentially outmoded healthcare technologies, and for related activities.

`SEC. 917. COORDINATION OF FEDERAL GOVERNMENT QUALITY IMPROVEMENT EFFORTS.

with private sector accreditation and other quality measurement organizations;

`PART C--GENERAL PROVISIONS

`SEC. 921. ADVISORY COUNCIL FOR HEALTHCARE RESEARCH AND QUALITY.

States. The Secretary shall ensure that the appointed members of the Council, as a group, are representative of professions and entities concerned with, or affected by, activities under this title and under section 1142 of the Social Security Act. Of such members--

`SEC. 922. PEER REVIEW WITH RESPECT TO GRANTS AND CONTRACTS.

practice-oriented or provider-based research, and for such other purposes as the Director may determine to be appropriate.

`SEC. 923. CERTAIN PROVISIONS WITH RESPECT TO DEVELOPMENT, COLLECTION, AND DISSEMINATION OF DATA.

`SEC. 924. DISSEMINATION OF INFORMATION.

`SEC. 925. ADDITIONAL PROVISIONS WITH RESPECT TO GRANTS AND CONTRACTS.

`SEC. 926. CERTAIN ADMINISTRATIVE AUTHORITIES.

to utilize the physical resources of such Department, and provide technical assistance and advice.

`SEC. 927. FUNDING.

`SEC. 929. DEFINITIONS.

SEC. 403. REFERENCES.

SEC. 404. STUDY.

TITLE V--ENHANCED ACCESS TO HEALTH INSURANCE COVERAGE

SEC. 501. FULL DEDUCTION OF HEALTH INSURANCE COSTS FOR SELF-EMPLOYED INDIVIDUALS.

SEC. 502. FULL AVAILABILITY OF MEDICAL SAVINGS ACCOUNTS.

SEC. 503. CARRYOVER OF UNUSED BENEFITS FROM CAFETERIA PLANS, FLEXIBLE SPENDING ARRANGEMENTS, AND HEALTH FLEXIBLE SPENDING ACCOUNTS.

extent that such amount is transferred in a trustee-to-trustee transfer, or is contributed within 60 days of the date of the distribution, to--

SEC. 504. PERMITTING CONTRIBUTION TOWARDS MEDICAL SAVINGS ACCOUNT THROUGH FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM (FEHBP).

END